Esbriet (pirfenidone) was as effective as prednisone and better than acetylcysteine to inhibit inflammation and fibrosis in the lungs of rats with idiopathic pulmonary fibrosis (IPF), according to one study.
The research, “Effects and mechanisms of pirfenidone, prednisone and acetylcysteine on pulmonary fibrosis in rat idiopathic pulmonary fibrosis models” was published in the journal Pharmaceutical Biology,
Proteins known as cytokines and other molecules play a crucial role in the progression of pulmonary fibrosis. They include tumor necrosis factor-α (TNF-α), transforming growth factor beta1 (TGF-β1), platelet-derived growth factor (PDGF) and caveolin-1 (Cav-1).
Studies have shown that changes in the functioning of Cav-1 may increase pulmonary fibrosis. Research has also shown that Cav-1 expression is significantly lower in the lung tissue of IOF patients than in healthy people.
The objective of the new study was to compare the impact of Esbriet, prednisone and acetylcysteine on the expression of Cav-1 in mice with IPF.
The researchers divided 75 male rats into five groups: the model M group, the Esbriet group P, the acetylcysteine N group, the hormone H (or prednisone) group and the control group C. The team presented the IPF To rats in all groups but
The rats of group M received 2 ml of normal saline at 0.9% twice daily, while the rats of groups P, N and H received the therapies for which they were programmed.
After 15, 30 and 45 days of treatment, the scientists evaluated five rats in each group for the degree of fibrosis and airsacculitis, or inflammation of the air sacs of the lungs. We also evaluated the expression of Cav-1 and the cytokines TNF-α, TGF-β1 and PDGF.
As expected, the rats in group C showed normal pulmonary structure. The scientists found that after 15 days, the rats in group M had mild inflammation and fibrosis. Symptoms worsened over the next 30 days.
In the three moments, the degree of fibrosis and airsacculitis was lower in the P, H and N groups than in the M group.
Although not statistically significant, the degree of inflammation in the air sacs of group P was greater than in group H, but smaller than group N. A difference in the fibrosis score was observed between groups P and H, but Was not statistically significant either. Interestingly, the fibrosis score in the P group was significantly lower than in the N group at all three time points.
Cav-1 expression was lower in all IPF groups than in the control group, the team found. Furthermore, in general, when Cav-1 expression increased, the degree of IFP symptoms decreased.
The researchers found a difference in the expression of the Cav-1 protein only between the P and H groups, with the Cav-1 P Group significantly higher than the H group.
There was an inverse correlation between Cav-1 expression and expression of TGF-β1, TNF-α and PDGF, which means that higher expression of Cav-1 was associated with lower expression of the others.
The team concluded that Esbriet was as effective in relieving symptoms of IPF as prednisone, and better than acetylcysteine. The results suggest that Esbriet, prednisone and acetylcysteine may increase the expression of Cav-1 and reduce the levels of TGF-β1, TNF-α and PDGF. They also suggested that Cav-1 is a major regulator of the IPF.